Hematopoietic Stem Cell Transplantation Clinical Trial
Official title:
Dose Study of Antithymocyteglobulin in Haploidentical Hematopoietic Stem Cell Transplantation for Acute Graft-versus-host Disease Prophylaxis
The purpose of this study is to compare the incidences of GVHD and viral infections in haploidentical hematopoietic stem cell transplant recipients receiving different dose of antithymocyte globulin (ATG) for acute graft-versus-host disease(aGVHD) prophylaxis. Our first objective was to investigate the optimal dose of ATG for aGVHD and second object was to evaluate the effect of different dose of ATG on post-transplant viral infection.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT)is the only therapeutic option
for many hematological malignancies. Unfortunately, about 75% of patients who require
allo-HSCT lack human leukocyte antigen (HLA)-matched donors. The alternative is hematopoietic
stem cells from an HLA-mismatched family donor. However, this strategy, which is called
haploidentical HSCT, may be associated with high risk of early death and severe GVHD.
Opportunistic infections are common complications after allo-HSCT. Due to the absence of
effective preventive and therapeutic drugs for most viruses, viral infections has become one
of the most important causes of death. The immunosuppression regimen including ATG has been
shown effective to prevent severe GVHD in haploidentical HSCT. But this strategy delays
immune reconstitution, and therefore increase the risk of viral infection.
The optimal dose of the different ATG preparations with respect to prevention of GvHD is not
fully understood today. The total doses between 6 mg/kg to 15 mg/kg are effective for
prevention of GVHD, but the dose above 10 mg/kg may increase the development of viral
infection.
In this trial, we will focus on the incidence of aGVHD and viral infections in patients
treated with 7.5mg/kg or 10mg/kg of ATG. The incidence of GVHD and viral infections will be
compared between different dose arms.
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